Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $95.50 / $398.11 / $602.56	Facility		$95.50	$398.11	$602.56
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $30.20 / $38.90 / $47.86	Facility	26	$30.20	$38.90	$47.86
Aetna Facility/Professional Professional Modifier Low / Median / High Price $48.98 / $93.33 / $316.23	Professional		$48.98	$93.33	$316.23
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $30.20 / $57.54 / $138.04	Professional	26	$30.20	$57.54	$138.04
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $60.26 / $154.88 / $630.96	Professional	50	$60.26	$154.88	$630.96
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $42.66 / $57.54 / $117.49	Professional	TC	$42.66	$57.54	$117.49
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $61.66 / $70.79 / $128.82	Professional		$61.66	$70.79	$128.82
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $23.99 / $30.20 / $47.86	Professional	26	$23.99	$30.20	$47.86
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $93.33 / $100.00 / $114.82	Professional	50	$93.33	$100.00	$114.82
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $37.15 / $50.12 / $81.28	Professional	TC	$37.15	$50.12	$81.28
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $83.18 / $234.42 / $346.74	Facility		$83.18	$234.42	$346.74
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $75.86 / $83.18 / $134.90	Professional		$75.86	$83.18	$134.90
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $28.18 / $33.11 / $53.70	Professional	26	$28.18	$33.11	$53.70
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $114.82 / $123.03 / $199.53	Professional	50	$114.82	$123.03	$199.53
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $47.86 / $50.12 / $79.43	Professional	TC	$47.86	$50.12	$79.43
CareSource Facility/Professional Facility Modifier Low / Median / High Price $37.15 / $58.88 / $104.71	Facility		$37.15	$58.88	$104.71
CareSource Facility/Professional Professional Modifier Low / Median / High Price $33.11 / $54.95 / $100.00	Professional		$33.11	$54.95	$100.00
Cigna Facility/Professional Facility Modifier Low / Median / High Price $114.82 / $346.74 / $346.74	Facility		$114.82	$346.74	$346.74
Cigna Facility/Professional Professional Modifier Low / Median / High Price $77.62 / $95.50 / $177.83	Professional		$77.62	$95.50	$177.83
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $27.54 / $41.69 / $66.07	Professional	26	$27.54	$41.69	$66.07
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $43.65 / $64.57 / $107.15	Professional	TC	$43.65	$64.57	$107.15
United Facility/Professional Facility Modifier Low / Median / High Price $66.07 / $74.13 / $109.65	Facility		$66.07	$74.13	$109.65
United Facility/Professional Professional Modifier Low / Median / High Price $74.13 / $93.33 / $141.25	Professional		$74.13	$93.33	$141.25
United Facility/Professional Professional Modifier 26 Low / Median / High Price $28.84 / $37.15 / $54.95	Professional	26	$28.84	$37.15	$54.95
United Facility/Professional Professional Modifier TC Low / Median / High Price $43.65 / $54.95 / $87.10	Professional	TC	$43.65	$54.95	$87.10